JOSPT: Humility and Acceptance: Working Within Our Limits With Long COVID and ME/CFS - Décary et al - 2021

Jonathan Edwards said:
I am not sure why. I don't see GET as a solution to anything. If people are able to do more and want to they can get on and do it. They don't need a therapist. If they find they cannot do it then either they shouldn't try, or if it is due to mistaken beliefs then I would have thought GET would be likely to entrench those beliefs and make things much worse.

Exercise ia good for prolonging healthy life but it really isn't so essential even there and I don't see it as a treatment for anything much. There are probably a few examples but I find it hard to think of any.
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What are the similarities, if any, between GET and standard treatment for people genuinely deconditioned, especially not convinced they are deconditioned.
 
Barry said:
What are the similarities, if any, between GET and standard treatment for people genuinely deconditioned, especially not convinced they are deconditioned.
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Not sure I follow. There isn't a particular treatment for people who deconditioned other than advising them that in the long term exercise is healthy so worth doing when they are up to it. If they are not convinced they are deconditioned then it may be uphill giving advice!
 
Does "deconditioned" actually exist? Less fit than before certainly does: in my case that wouldn't take much proof. But before I had ME I was pretty fit and active. Many of my colleagues were less so. Is there a magic level at which they could be deemed to be deconditioned? Could I have been described as deconditioned because I counld have been fitter? Are all physically disabled people automatically deconditioned because they can't reach the same levels?

I don't think "deconditioned" does exist, other than being less fit than before, which of course can occur with age, or quite simply, with a change in interests or employment. After a year on and off in hospital, I am certainly much less fit and have much less strength than I did. I am slowly improving. But who defines what my target fitness level should be? Is it only acceptable when I reach my physical peaK? If so, virtually everyone is deconditioned.

And what about cognitive fitness? Do I need cogniotherapy?
 
Jonathan Edwards said:
Not sure I follow. There isn't a particular treatment for people who deconditioned other than advising them that in the long term exercise is healthy so worth doing when they are up to it. If they are not convinced they are deconditioned then it may be uphill giving advice!
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Maybe I'm wrong then. I though people could become severely deconditioned under some circumstance, such as when totally bedridden for a long time, or a long time in space etc. I thought even bone mass could deteriorate etc. Is it always possible to get back to full health unaided, for all people?
 
Barry said:
Maybe I'm wrong then. I though people could become severely deconditioned under some circumstance, such as when totally bedridden for a long time, or a long time in space etc.
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I had two weeks of bronchitis 31 years ago when I was a robust 33-year-old. It took me two months not to be exhausted from anything. No one needed to tell me how to recover once I was told that a slow recovery was normal. Maybe for some people a program would be needed but I'm not sure why. I would guess that most people who are "deconditioned" after a viral illness and nothing more just do it in their own time.
 
Barry said:
Maybe I'm wrong then. I though people could become severely deconditioned under some circumstance, such as when totally bedridden for a long time, or a long time in space etc. I thought even bone mass could deteriorate etc. Is it always possible to get back to full health unaided, for all people?
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People can certainly get severely deconditioned but I don't know of any evidence that they need more than following their natural body signals as they get back to doing things.
 
Barry said:
How do you access Sci-Hub these days? I seem to have lost the ability to connect to it.
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Arnie Pye said:
Access to Sci-Hub in the UK has been disallowed by many ISPs as a result of a court judgement in favour of the copyright holders.

https://www.ispreview.co.uk/index.p...uk-isp-talktalk-to-block-sci-hub-website.html

The above link mentions TalkTalk but all the biggest ISPs have followed suit, including my own.
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You can use Tor browser to get around that, if you'd like:

https://www.torproject.org/download/
 
There are some great comments beneath David's latest piece. Here's one by Alida Miller:
It is simply amazing to me that anyone with a scientific, medical or health background could fail to see the deep flaws so clearly evident in the PACE study & associated published literature.

A total lay-person armed only with an enquiring mind & attention to detail is more than able to identify fundamental flaws that go beyond simple mistakes & jump off the page as amateurish attempts to manipulate the results.

As a former scientist, – now living with severe ME – I am further amazed that the peer-review process so fundamental to accepted scientific process failed to identify glaring issues in experimental design, data collection, & analysis.

I simply cannot comprehend how Peer reviewers let this, & other papers, be accepted.

And one has to wonder why the journals, & their editors, were willing to publish such deceptive ‘work’.

A quick check of the key names involved in this deception reveals a virtually revolving door of the same names either doing the studies, reviewing the work, or publishing the outcomes.

In so doing they have displayed ongoing disrespect for patient wellbeing & scientific rigour.

Untold numbers of patients have been harmed physically & emotionally by the resulting inappropriate treatments which continues to this day; yet the eminence-based ‘science’ continues to be promulgated by health practitioners who have either not read the actual studies, or scarier still, have not understood the many flaws in the PACE trial & related studies.

Berkeley based public health academic & investigative journalist David Tuller is a leading researcher calling this cabal to account; yet PACE-styled Graded Exercise Training & its accompanying Cognitive Behaviour Therapy is still recommended to this day.

If the peer review process repeatedly refuses to reject shoddy ‘science’ then peer review itself must be regarded with suspicion at the least, & perhaps be totally disregarded.

That a handful of ‘scientists’ are prepared to harm patients & tear down fundamental practices of scientific process simply to gain further ‘eminence’ & presumably personal profit also amazes me.

But that the scientific, medical & health professional communities do not stand as one with patients & call out these people & their unethical practices astounds me.

We are all diminished as a result.
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And jimells says something I think many of us would agree with:
The illness wrecked my health, but it was the medical industry that wrecked my life.
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